The nurse is taking the history of a gravida 2 para 1 patient. Which findings in the patient's history warrant further action? Select ONE that des nont apply.

Correct Answer: D

Rationale: In the context of perinatal loss nursing care, it is essential for the nurse to identify potential risk factors and complications that can impact the health and well-being of the mother and the unborn child. In this scenario, the correct answer is D) Malnutrition, which warrants further action in the patient's history. Malnutrition can have serious implications for both the mother and the developing fetus during pregnancy. It can lead to an increased risk of complications such as low birth weight, preterm birth, and developmental issues for the baby. Additionally, malnutrition can also affect the mother's health, leading to conditions like anemia, infections, and impaired wound healing post-delivery. Option A) Anemia, option B) Severe hemorrhage, and option C) Infections are all important factors to consider in perinatal care; however, they are more commonly associated with immediate risks during pregnancy and childbirth. While they require attention and intervention, malnutrition has long-term consequences that can impact both the current pregnancy and future pregnancies if not addressed. In an educational context, understanding the significance of a comprehensive health history assessment in perinatal care is crucial for providing holistic and effective nursing care. By recognizing the impact of factors like malnutrition on pregnancy outcomes, nurses can implement targeted interventions and support strategies to promote the health and well-being of both the mother and the baby.

Correct Answer: B

Rationale: The correct answer is B) Orange juice. When a physician orders an iron supplement for a postpartum woman, it is crucial to consider the bioavailability of iron. Iron is better absorbed in the presence of vitamin C, which helps convert iron into a more easily absorbable form. Orange juice is rich in vitamin C, making it an ideal choice to enhance iron absorption from the supplement. Option A) Milk is not the best choice because calcium found in milk can inhibit iron absorption. Calcium competes with iron for absorption in the intestines, reducing the effectiveness of the iron supplement. Options C) Coffee and D) Tea contain compounds known as tannins, which can also interfere with iron absorption. Tannins can bind to iron, forming complexes that are poorly absorbed by the body. Therefore, coffee and tea are not recommended to be taken with iron supplements. In an educational context, understanding the importance of proper iron supplementation in postpartum care is essential for nurses caring for women during this vulnerable period. By knowing which drinks enhance or inhibit iron absorption, nurses can provide evidence-based recommendations to support optimal maternal health and recovery after childbirth. This knowledge empowers nurses to advocate for the best practices in perinatal care and promote positive outcomes for women experiencing perinatal loss.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Dizziness. When a gravid at 36 weeks gestation lies flat on her back, she may experience supine hypotensive syndrome due to compression of the inferior vena cava by the weight of the uterus. This can lead to decreased blood flow returning to the heart, resulting in symptoms like dizziness. A) Hypertension is unlikely in this context as lying flat on the back would not typically cause hypertension. C) Rales (abnormal crackling sounds heard on auscultation of the lungs) are not directly related to the position of the gravid lying flat on her back. D) Chloasma (skin discoloration often seen in pregnant women) is a cosmetic concern and not a direct result of lying on the back. Educationally, it is important for nurses caring for pregnant individuals to understand the physiological changes that occur during pregnancy and how certain positions or actions can impact both the mother and the fetus. This knowledge helps in providing safe and effective care to prevent complications such as supine hypotensive syndrome.

Correct Answer: B

Rationale: In the context of perinatal loss nursing care, it is crucial for educators to ensure that clients have a clear understanding of the role of amniotic fluid and the amniotic sac in pregnancy. Option B, "Fetal nutrients are provided by the amniotic fluid," is the correct answer that indicates the need for further teaching. While amniotic fluid serves various functions, such as providing a cushion against impact and helping regulate fetal temperature, it does not serve as the primary source of fetal nutrients. Fetal nutrients are primarily derived from the placenta through the umbilical cord. Option A, "The amniotic fluid helps to dilate the cervix once labor begins," is incorrect because the amniotic fluid does not play a direct role in cervical dilation. Cervical dilation is primarily influenced by uterine contractions during labor. Option C, "Amniotic fluid provides a cushion against the impact of the abdominal wall," is incorrect because this statement is accurate. Amniotic fluid does act as a cushion, protecting the fetus from external pressure or impact. Option D, "The amniotic sac helps regulate fetal temperature," is incorrect as well. The amniotic sac helps to maintain a stable environment for the fetus by providing protection and space but does not play a significant role in regulating fetal temperature. In an educational context, it is essential to clarify misconceptions and provide accurate information to clients to support their understanding of the physiological processes during pregnancy. By addressing misunderstandings and reinforcing correct information, educators can empower clients to make informed decisions and feel confident in their knowledge about perinatal care.

Correct Answer: B

Rationale: In the context of advocating for improved prenatal care services in the community, the most important information to include is the infant mortality rate (Option B). Infant mortality rate reflects the number of deaths of infants under one year of age per 1,000 live births. This rate is a critical indicator of the overall health and well-being of a population, including the impact of prenatal care on infant outcomes. The other options are not as directly relevant to the need for improved prenatal care services in the community. Maternal mortality rate (Option A) focuses on the deaths of mothers related to childbirth, which while important, may not directly reflect the need for improved prenatal care services. Perinatal mortality rate (Option C) includes stillbirths and early neonatal deaths, which are also important but may not convey the specific impact of prenatal care on infant survival. Neonatal mortality rate (Option D) specifically looks at deaths that occur within the first 28 days of life, which is important but does not capture the broader impact of prenatal care on overall infant health outcomes. Educationally, understanding the nuances of different mortality rates can help nurses and healthcare providers advocate for targeted interventions and resources to improve perinatal outcomes. By focusing on the infant mortality rate, healthcare professionals can better identify areas for improvement in prenatal care services to ultimately reduce infant deaths in the community.